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� ° ' CITY OF ORONO * 2 0 1 6 - 0 0 7 7 3 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 07/18/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1150 HOMESTEAD TR <br /> PIN : 28-118-23-32-0018 <br /> LEGAL DESC : UNPLATTED 28 118 23 <br /> : LOT MB BLOCK MB <br /> PERMIT TYPE : SEPTIC <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : SEPTIC(NEW OR REPLACEMENT) <br /> ACTIVITY : SEPTIC(MOUND) <br /> NOTE: PRECAST CONCRETE TANKS <br /> (1) 1250 GALLON,(1) 1000 GALLON AND(1) 1250 LIFT STATION <br /> APPLICANT SEPTIC NEW OR REPLACEMENT 400.00 <br /> CUSTOM SEPTIC INC. TOTAL 400.00 <br /> 32749 199TH AVE Payment(s) <br /> CREDIT CARD 0883 400.00 <br /> MENAHGA, MN 56464- <br /> (763)218-4769 <br /> Minnesota State License#: sept-1744R4346 <br /> OWNER <br /> MARIANI, DAVE&DEANNA <br /> 1150 HOMESTEAD TR <br /> LONG LAKE,MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which[his permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for addi[ional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time afrer work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. " <br /> S �� —� l �'GJ � /( �^/� <br /> Y� � <br /> Applicant ermitee Signature Date Issued Signature Date <br />